Rehabilitation of children with post-burn scars of the distal limbs
DOI: 10.32364/2618-8430-2021-4-2-168-172
O.V. Filippova, K.A. Afonichev
G.I. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery, Pushkin, St. Petersburg, Russian Federation
Background: rehabilitation after burns of the distal limbs is a challenging process due to many small joints and heavy functional load. During active growth periods, the risk of rapid progression of deformities is particularly high as intensive growth under scarring may result in sprains and even bone angulation. Regular monitoring is a prerequisite for adequate treatment.
Aim: to analyze the rate and terms of the development of foot deformities in children of various ages and the actual amount of rehabilitation measures based on clinical anamnestic data.
Patients and Methods: anamnestic data, clinical presentations, and X-ray exams of 65 children with foot deformities who were managed in the G.I. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery in 2015–2019 were analyzed. All children were distributed across age groups.
Results: the analysis of anamnestic data revealed an inadequate amount of preventive rehabilitation measures after skin integrity recovery. In half of the patients, conservative therapy included anti-scarring creams and gels and, occasionally, compression clothing. The highest rate of scar deformities requiring surgery was reported in preschool and early school children (these are the ages of rapid growth). In preschool children, scar deformities are significantly m ore common in the earliest period (up to 2 years after epithelization).
Conclusion: rehabilitation of children after burns should be continued until a child stops growing. These measures should include complementary surgical and conservative treatment in both in-patient and out-patient departments.
Keywords: burn, scar deformities, foot deformities, check-up of children after burns, prevention of scarring.
For citation: Filippova O.V., Afonichev K.A. Rehabilitation of children with post-burn scars of the distal limbs. Russian Journal of Woman and Child Health. 2021;4(2):168–172. DOI: 10.32364/2618-8430-2021-4-2-168-172.
About the authors:
Olga V. Filippova — Doct. of Sci. (Med.), leading researcher of the Department of Injury Consequences & Rheumatoid Arthritis, G.I. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery; 64–68, Parkovaya str., Pushkin, St. Petersburg, 196603, Russian Federation; ORCID iD 0000-0002-1002-0959.
Konstantin A. Afonichev — Doct. of Sci. (Med.), Head of the Department of Injury Consequences & Rheumatoid Arthritis, G.I. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery; 64–68, Parkovaya str., Pushkin, St. Petersburg, 196603, Russian Federation; ORCID iD 0000-0002-6460-2567.
Contact information: Olga V. Filippova, e-mail: olgafil-@mail.ru. Financial Disclosure: no authors have a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 16.06.2020, revised 14.07.2020, accepted 04.08.2020.
2. Baindurashvili A.G., Kaleva T.A., Afonichev K.A. Prevention of the consequences of burns in children. Rossiyskiy vestnik detskoy khirurgii, anesteziologii i reanimatologii. 2012;25–26 (in Russ.).
3. Lu H. Relation of early wound treatment and late deformity in burned children. Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1990;6(2):89–90, 156 (in Chinese)].
4. Fernandez-Palacios J., De Armas Diaz F., Deniz Hernandez V. et al. Radial free flaps in plantar burns. Burns. 1996;22:242. DOI: 10.1016/0305-4179 (95) 00128-X
5. Pham T.N., Goldstein R., Carrougher G.J. et al. The impact of discharge contracture on return to work after burn injury: A Burn Model System investigation. Burns. 2020;46(3):539–545. DOI: 10.1016/j.burns.2020.02.001.
6. Grishkevich V.M., Moroz V. Yu. Surgical treatment of the consequences of burns of the lower extremities. M.; 1996 (in Russ.).
7. Mikhaylov I.A. Surgical treatment of the consequences of foot and ankle burns: thesis. M.; 1992 (in Russ.).
8. Carmichael K.D., Maxwell S.C., Calhoun J.H. Recurrence rates of burn contracture ankle equinus and other foot deformities in children treated with Ilizarov fixation. J Pediatr Orthop. 2005;25(4):523–528. DOI: 10.1097/01.bpo.0000161093.31092.c4
9. Korolev P.V., Tkachenko E.I. The value of timely treatment of thermal injury in functionally active zones in children. Thermal injury problems in children and adolescents. Yekaterinburg; 2003 (in Russ.).
10. Afonichev K.A., Nikitin M.S., Kuptsova O.A. Treatment of post-burn secondary deformity of the foot. Ortopediya, travmatologiya i vosstanovitel’naya khirurgiya detskogo vozrasta. 2015;3(2):52–55 (in Russ.).
11. Kucan J.O., Bash D. Reconstruction of the burned foot. Clin. Plast. Surg. 1992;19:705. DOI: 10.1097/01.bpo.0000161093.31092.c4.
12. Kurinnyy N.A., Romanenko A.A. Surgical treatment of post-burn deformities of the dorsum of the foot and ankle joint in children. Materials of the International Congress "Combustiology at the turn of the century". M.; 2000:196–197 (in Russ.).
13. Ostrovsky N.V., Belyanina I.B., Yakunin G.S. The choice of terms and methods for eliminating cicatricial deformities in children. Thermal injury problems in children and adolescents. Yekaterinburg; 2003 (in Russ.).
14. Shaughnessey M.O., Zinn A.G., Vidal P. et al. The problem of bilateral foot reconstruction after severe burns. Br J Plast Surg. 1996;49:233. DOI: 10.1016/S0007-1226 (96) 90057-0.
15. Alekseev A.A., Kudzoev O.A., Klimento M.V., Shmelkin B.V. Modern means of prevention and treatment of post-burn scars. Conservative scar treatment. Materials of the symposium. M.; 2000 (in Russ.).
16. Mishakova T.V., Ostapenko V.I., Chadov V.I. et al. Possibilities of compression therapy in the complex rehabilitation of post-burn pathological scars in children with thermal trauma. Materials of the International Congress “Combustiology at the turn of the century”. M.; 2000 (in Russ.).
17. Filippova O.V. Surgical and morphological aspects of the treatment of cicatricial deformities in children: thesis. SPb.; 2015 (in Russ.).
18. Afonichev K.A., Filippova O.V. Dispensary observation of children who have suffered burns. Ortopediya, travmatologiya i vosstanovitel’naya khirurgiya detskogo vozrasta. 2015:3(1):32–37 (in Russ.).
19. Dantzer E., Querval P., Salinier L. et al. Dermal regeneration template for deep hand burns: clinical utility both early grafting and reconstructive surgery. Br J Plast Surg. 2003;56:764–777. DOI:10.1016/s0007–1226 (03) 00366–7.

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